Associação da Lipoenxertia no tratamento de cicatrizes de queimadura: um relato de caso / Association of Lipoenxertia in the treatment of burn scars: a case report

Queimaduras são grandes responsáveis pelas taxas atuais de morbimortalidade e gastos em assistência no Brasil. Além das afecções estéticas, a cicatrização pós-queimadura pode trazer prejuízos à qualidade de vida do paciente dentro de seu desenvolvimento funcional, social e psicológico. No entanto, apesar de notáveis progressos no manejo da cicatrização de feridas, as opções terapêuticas ainda são um desafio para a classe médica, já que não há uma terapia padrão-ouro que elimine de forma totalmente eficaz o excesso de tecido cicatricial. Nesse contexto, a lipoenxertia surge como uma técnica terapêutica promissora que consiste na injeção de tecido adiposo autólogo para reconquistar um pouco do suporte mecânico e vascular da região subcutânea previamente destruída nas queimaduras graves com o apoio das propriedades regenerativas dos componentes celulares carregados nas amostras. Portanto, o presente trabalho objetiva descrever o caso de uma paciente adulta, vítima de queimaduras, apresentando a evolução dos resultados sob a luz dos mecanismos de ação envolvidos no reparo da cicatriz pela enxertia de gordura autóloga realizada em consonância com a literatura

Study of Natural Cytotoxicity Receptors in Patients with HIV/AIDS and Cancer: A Cross-Sectional Study

The NCR receptors play a fundamental role in the cytotoxicity mediated by NK cells against tumor cells. In the current study, we investigated possible HIV/AIDS-related changes in the expression of the NCR receptors comparing healthy donors, HIV/AIDS patients, and HIV/AIDS patients with cancer (HIV/AIDSWC). The NCRs were quantified in NK cells (NKdim and NKbright) and T lymphocytes from peripheral blood samples by flow cytometry. We found a significant decrease in the frequency of NK cells expressing NKp46 in HIV/AIDS group (p=0.0012). There was a decrease in the frequency of NK cells expressing NKp46 in the HIV/AIDSWC group; however, this was not statistically significant. We found a significant decrease in the frequency of NK cells expressing NKp30 in the HIV/AIDS group (p=0.0144). There was a decrease in the frequency of NK cells expressing NKp30 and in the HIV/AIDSWC group, but this was not statistically significant. There were no changes in the distribution of NK cells and their subtypes in both groups

Effect of Virgin PP Substitution with Recycled Plastic Caps in the Manufacture of a Product for the Telephony Sector

This study investigated the effects of partial and total substitutions of fossil polypropylene (PP) for recycled plastic cap equivalents in the manufacture of signage labels used by the telephone industry. Four alternative scenarios to using virgin PP were evaluated considering recycled material in flake and pellet forms based on environmental performance, degree of circularity, and technical behavior. The environmental analysis was performed by the life cycle assessment (LCA) technique, and for all impact categories evaluated, using recycled material to replace the virgin reduced adverse effects on the environment. The most significant results in this dimension, with gains of 81% in the Global Environmental Indicator, occurred when recycled PP flakes entirely replaced the fossil polymer. Once again, the highest values of the Materials Circularity Indicator (MCI) were achieved by scenarios with full recycled resin in processing the tags; however, this product must also be reused. The mechanical behavior of the tags measured technical performance, and in this case, the product made with virgin PP outperformed the recycled options except for elongation. An analysis that integrated the three dimensions into a single performance index pointed to the complete substitution of virgin material for recycled as the most balanced option

High levels of pro-inflammatory SARS-CoV-2-specific biomarkers revealed by in vitro whole blood cytokine release assay (CRA) in recovered and long-COVID-19 patients.

BackgroundCytokines induced by SARS-CoV-2 infection play a crucial role in the pathophysiology of COVID-19 and hyperinflammatory responses have been associated with poor clinical outcomes, with progression to severe conditions or long-term subacute complications named as long-COVID-19.MethodsIn this cross-sectional study, we aimed to evaluate a set of antigen-specific inflammatory cytokines in blood from recovered COVID-19 individuals or who suffered a post-acute phase of SARS-CoV-2 infection compared to healthy individuals with no history of COVID-19 exposition or infection. Interferon-gamma (IFN-γ), IFN-γ-induced protein 10 (IP-10), tumor necrosis factor (TNF), IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, and IL-17A were quantified by multiplex cytometric bead assay and enzyme-linked immunosorbent assay after stimulation of whole blood with recombinant Spike protein from SARS-CoV-2. Additionally, all participants have evaluated for anti-(S) protein-specific IgG antibodies. Clinical specimens were collected within two months of COVID-19 diagnosis.ResultsA total of 47 individuals were enrolled in the study, a median age of 43 years (IQR = 14.5), grouped into healthy individuals with no history of infection or exposure to SARS-CoV-2 (unexposed group; N = 21); and patients from the Health Complex of the Rio de Janeiro State University (UERJ), Brazil, who were SARS-CoV-2 positive by RT-PCR (COVID-19 group)-categorized as recovered COVID-19 (N = 11) or long-COVID-19 (N = 15). All COVID-19 patients presented at least one signal or symptom during the first two weeks of infection. Six patients were hospitalized and required invasive mechanical ventilation. Our results showed that COVID-19 patients had significantly higher levels of IFN-γ, TNF, IL-1β, IL-2, IL-6, IL-8, and IP-10 than the unexposed group. The long-COVID-19 group has presented significantly high levels of IL-1β and IL-6 compared to unexposed individuals, but not from recovered COVID-19. A principal-component analysis demonstrated 84.3% of the total variance of inflammatory-SARS-CoV-2 response in the first two components, and it was possible to stratify IL-6, TNF, IL-1β, IL-10, and IL-2 as the top-five cytokines which are candidates to discriminate COVID-19 group (including long-COVID-19 subgroup) and healthy unexposed individuals.ConclusionWe revealed important S protein-specific differential biomarkers in individuals affected by COVID-19, bringing new insights into the inflammatory status or SARS-CoV-2 exposition determination

External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs

Abstract Background The performance of severity-of-illness scores varies in different scenarios and must be validated prior of being used in a specific settings and geographic regions. Moreover, models’ calibration may deteriorate overtime and performance of such instruments should be reassessed regularly. Therefore, we aimed at to validate the SAPS 3 in a large contemporary cohort of patients admitted to Brazilian ICUs. In addition, we also compared the performance of the SAPS 3 with the MPM0-III. Methods This is a retrospective cohort study in which 48,816 (medical admissions = 67.9%) adult patients are admitted to 72 Brazilian ICUs during 2013. We evaluated models’ discrimination using the area under the receiver operating characteristic curve (AUROC). We applied the calibration belt to evaluate the agreement between observed and expected mortality rates (calibration). Results Mean SAPS 3 score was 44.3 ± 15.4 points. ICU and hospital mortality rates were 11.0 and 16.5%. We estimated predicted mortality using both standard (SE) and Central and South American (CSA) customized equations. Predicted mortality rates were 16.4 ± 19.3% (SAPS 3-SE), 21.7 ± 23.2% (SAPS 3-CSA) and 14.3 ± 14.0% (MPM0-III). Standardized mortality ratios (SMR) obtained for each model were: 1.00 (95% CI, 0.98–0.102) for the SAPS 3-SE, 0.75 (0.74–0.77) for the SAPS 3-CSA and 1.15 (1.13–1.18) for the MPM0-III. Discrimination was better for SAPS 3 models (AUROC = 0.85) than for MPM0-III (AUROC = 0.80) (p < 0.001). We applied the calibration belt to evaluate the agreement between observed and expected mortality rates (calibration): the SAPS 3-CSA overestimated mortality throughout all risk classes while the MPM0-III underestimated it uniformly. The SAPS 3-SE did not show relevant deviations from ideal calibration. Conclusions In a large contemporary database, the SAPS 3-SE was accurate in predicting outcomes, supporting its use for performance evaluation and benchmarking in Brazilian ICUs